Fig. 38-1, p. 993

Physiologic Differences Between Children and Adults That Affect Pharmacokinetics

1

Giving Medications: what’s the same?

Safety & accuracy 6 Rights

Understand expected action and side effectsSigns of toxicity, adverse reactions

2

Extra Considerations for Children

Safe volume (IM)Po often liquidDosage by body weightCheck dosage with reference Mg/kg/dose or mg/kg/day?

Check calculations with another nurse

3

Example

1. Order: Augmentin 200 mg po q. 12 hrsChild: 9.5 kgAvailable: suspension 125 mg/5 mLRange (drug book) 25-45 mg/kg/dayIs dose within range?How many ml is required to give the ordered dose?

4

Principles of Medication Administration

in Children

Consider growth and development principles.Honesty and praise help to gain trust and cooperation.Restraint may be necessary.Provide rewards for good behavior and for trying.Dosages by body wt

5

Safety Considerations

Children unpredictableGet help with restrainingExtra needleParent/caregiver involvementBe quick, skillfulNever give injection to a sleeping child

6

Must Know:

1 Kg = 2.2 lbs1 Kg = 1,000 gm1 Gm = 1,000 mg

Kg = lbs 2.2

Kg x 2.2 = lbs7

Strategies for Medicating Children

Infants Restrain cuddle, comfort.

Toddlers Use play minimize restraint give praise stickers as rewards.

F8

Strategies for Medicating Children

Pre-school, early school-age Provide choices, explanations Distraction Support

Adolescents Explain Allow participation in decisions praise cooperation provide outlet for frustrations.

9

Methods of Administering Medications to Children

OralNG, GT, JTRectalTopicalOtic (ear)Ophthalmic (eye) IVIntraosseous IM, SQ

10

Giving oral meds

11

Gastric or NG Meds

Stop feeding (as appropriate)Flush with (sterile) water – 5-25 mLAdminister medFlushAlways flush when stopping feeding

12

Ear drops

13

Intramuscular Sites in Childrentable 38-1

Fig. 38-UF01a, p. 999

14

Intramuscular Sites in Children

Fig. 38-UF01b, p. 999 MEN

15

IM

16

Procedure for Pediatric IM

Look at procedure in syllabus

17